Over many years, various efforts by the Department of Occupational Safety and Health (DOSH) have been carried out to reduce the the number of people who are killed as a result of construction work. Despite various safety and health initiatives by DOSH, other authority and the industry, the construction site remains dangerous. What is more worrying is that almost all of the deaths and injuries that occur are foreseeable and preventable. Currently, DOSH is committed to improve safety and health in the construction industry by focusing on high risk activities, and other initiatives outline in the Occupational Safety and Health Master Plan 2016-2020. Securing safety and health in the construction industry is a huge task, and all stakeholders (clients, designers and contractors) in the industry must work hand in hand and be ready to shoulder the responsibility to bring about change and improvements in safety and health performance. The proposed Guidelines of Occupational Safety and Health in Construction Industry (Management) is the key driving improvement to the safety and health performance in the construction industry.